Patient knowledge of upper respiratory infections: Implications for antibiotic expectations and unnecessary utilization

Mainous III, Arch G.; Zoorob, Roger J.; Oler, Michael J.; Haynes, Delicia M.
July 1997
Journal of Family Practice;Jul1997, Vol. 45 Issue 1, p75
Academic Journal
BACKGROUND. Upper respiratory infections (URIs) account for many of the visits in primary care and are commonly treated with ineffective antibiotic therapy. The purpose of this study was to examine patient beliefs in the effectiveness of antibiotics and the likelihood of seeking care for normal presentations of URIs. METHODS. We conducted a survey of 961 adults (≥18 years of age) from an undifferentiated patient population in a university-based family practice residency clinic in metropolitan Kentucky, a private internal medicine practice in nonmetropolitan Kentucky, and, in metropolitan Louisiana, an emergency department and a convenience sample from the community. RESULTS. Seventy-two percent of the sample reported that they would seek care with a condition of 5 days' duration with cough, sore throat, and discolored nasal discharge. Sixty-one percent of the sample expressed their belief that antibiotics are effective for a condition of 5 days' duration with cough, sore throat, and clear nasal discharge; 79% said that they believed antibiotics are effective when there is discolored discharge (P =.0001). Medicaid recipients were most likely to seek care across the symptom complexes. Higher education was related to a decreased belief in the effectiveness of antibiotics for the scenario with clear discharge (P.001), but to an increased belief in the effectiveness of antibiotics in the scenario with discolored discharge (P =.003). The strongest predictor of both likelihood of utilization and belief in effectiveness of antibiotics was usual use of antibiotics for the URI symptom complexes. CONCLUSIONS. Patients lack understanding of the normal presentation of a URI and the effectiveness of antibiotics as a treatment. A confusion about the meaning of discolored nasal discharge is particularly evident, and past antibiotic use may contribute to inappropriate utilization and expectations for antibiotics.


Related Articles

  • Predicting the duration of symptoms in lower respiratory tract infection. Moore, Michael; Little, Paul; Rumsby, Kate; Kelly, Jo; Watson, Louise; Warner, Greg; Fahey, Tom; Williamson, Ian // British Journal of General Practice;Feb2008, Vol. 58 Issue 547, p88 

    Background Acute lower respiratory tract infection (LRTI) presenting in primary care has a long natural history. Antibiotic treatment makes little or no difference to the duration of cough. Limited information is currently available regarding predictors of illness duration. Aim To determine...

  • Towards clinical definitions of lower respiratory tract infection (LRTI) for research and primary care practice in Europe: an international consensus study. Greene, Giles; Hood, Kerenza; Little, Paul; Verheij, Theo; Goossens, Herman; Coenen, Samuel; Butler, Christopher C. // Primary Care Respiratory Journal;Sep2011, Vol. 20 Issue 3, p299 

    Aims: Antibiotic prescriptions for lower respiratory tract infection (LRTI) account for a large proportion of antibiotic consumption. Many of these prescriptions do not benefit patients and contribute to antibiotic resistance. Research to improve evidence-based management requires clear...

  • Selective decrease in consultations and antibiotic prescribing for acute respiratory tract infections in UK primary care up to 2006. Gulliford, Martin; Latinovic, Radoslav; Charlton, Judith; Little, Paul; Staa, Tjeerd van; Ashworth, Mark // Journal of Public Health;Dec2009, Vol. 31 Issue 4, p512 

    Background: The aim of this study was to estimate trends in primary care consultations and antibiotic prescribing for acute respiratory tract infections (RTIs) in the UK from 1997 to 2006.

  • Missed opportunities for earlier treatment? A qualitative interview study with parents of children admitted to hospital with serious respiratory tract infections. Francis, Nick A.; Crocker, Joanna C.; Gamper, Arla; Brookes-Howell, Lucy; Powell, Colin; Butler, Christopher C. // Archives of Disease in Childhood -- Fetal & Neonatal Edition;Feb2011, Vol. 96 Issue 2, p154 

    Objective To identify potential opportunities for earlier intervention among children who develop a complicated respiratory tract infection (RTI). Design Qualitative, face-to-face, individual interview study, either in hospital or at home, with parents of children admitted to hospital with a...

  • Treatment of acute cough/lower respiratory tract infection by antibiotic class and associated outcomes: a 13 European country observational study in primary care. Butler, Christopher C.; Hood, Kerenza; Kelly, Mark J.; Goossens, Herman; Verheij, Theo; Little, Paul; Melbye, Hasse; Torres, Antoni; Mölstad, Sigvard; Godycki-Cwirko, Maciek; Almirall, Jordi; Blasi, Francesco; Schaberg, Tom; Edwards, Peter; Rautakorpi, Ulla-Maija; Hupkova, Helena; Wood, Joseph; Nuttall, Jacqui; Coenen, Samuel // Journal of Antimicrobial Chemotherapy (JAC);Nov2010, Vol. 65 Issue 11, p2472 

    Objectives Acute cough/lower respiratory tract infection (LRTI) is one of the commonest reasons for consulting and antibiotic prescribing. There are theoretical reasons why treatment with particular antibiotic classes may aid recovery more than others, but empirical, pragmatic evidence is...

  • Reducing uncertainty in managing respiratory tract infections in primary care. Stanton, Naomi; Francis, Nick A.; Butler, Chris C. // British Journal of General Practice;Dec2010, Vol. 60 Issue 581, p916 

    Respiratory tract infections (RTIs) remain the commonest reason for acute consultations in primary care in resource-rich countries. Their spectrum and severity has changed from the time that antibiotics were discovered, largely from improvements in the socioeconomic determinants of health as...

  • Antibiotics for acute cough: an international observational study of patient adherence in primary care. Francis, Nick; Gillespie, David; Nuttall, Jacqueline; Hood, Kerenza; Little, Paul; Verheij, Theo; Coenen, Samuel; Cals, Jochen W.; Goossens, Herman; Butler, Christopher C. // British Journal of General Practice;Jun2012, Vol. 62 Issue 599, p304 

    The article discusses a study on the consumption of antibiotics by adults during the 28 days after a consultation for acute cough or lower respiratory tract infection in primary care. It aims to identify factors associated with non-adherence and describe the relationship between antibiotic...

  • Unnecessary Prescriptions for Broad-Spectrum Antibiotics. Wellbery, Caroline // American Family Physician;7/15/2003, Vol. 68 Issue 2, p370 

    Discusses the study 'Predictors of Broad-Spectrum Antibiotic Prescribing for Acute Respiratory Tract Infections in Adult Primary Care,' by M.A. Steinman et al., from the February 12, 2003 issue of the 'Journal of the American Medical Association.'

  • Procalcitonin-guided antibiotic treatment of respiratory tract infections in a primary care setting: are we there yet? Aabenhus, Rune; Jensen, Jens-Ulrik Stæhr // Primary Care Respiratory Journal;Dec2011, Vol. 20 Issue 4, p360 

    Clinical signs of infection do not allow for correct identification of bacterial and viral aetiology in acute respiratory infections. A valid tool to assist the clinician in identifying patients who will benefit from antibiotic therapy, as well as patients with a potentially serious infection,...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics